Purpose To observe the right ventricle and left ventricle blood pool T2 map in chronic thromboembolic pulmonary hypertension(CTEPH)and healthy controls,and to analyze the value of T2 mapping technique in evaluating CTEPH.Materials and Methods A total of 42 patients with CTEPH and 42 healthy volunteers had been prospectively recruited from January 2020 to January 2022 in China-Japan Friendship Hospital.All CTEPH patients underwent cardiac magnetic resonance with T2 mapping and right heart catheterization.Cardiac magnetic resonance was performed on healthy controls.Diastolic T2 mapping was performed in cardiac magnetic resonance,and then the ratio of right ventricular to left ventricular T2 values(RVT2/LVT2)between the CTEPH group and the healthy group was calculated and compared.Meanwhile,the correlation between RVT2/LVT2 and hemodynamic parameters in the CTEPH group was analyzed.Results RVT2/LVT2 in the CTEPH group was significantly lower than that in the healthy group(0.74±0.16 vs.0.86±0.12;t=3.673,P<0.001).RVT2/LVT2 in CTEPH group was negatively correlated with pulmonary vascular resistance(r=-0.534,P<0.001);while it was positively correlated with cardiac index,right atrium oxygen saturation,right ventricle oxygen saturation and pulmonary arteries oxygen saturation(r=0.600,0.603,0.648,0.582,P<0.001).Conclusion RVT2/LVT2 in the CTEPH group is positively correlated with right cardiac oxygen saturation and negatively correlated with pulmonary vascular resistance.T2 mapping may be a noninvasive evaluation of hemodynamics in CTEPH.

Objective To analyze the imaging features of pulmonary artery sarcoma(PAS)on CT and MRI.Methods The clini-cal features,CT and MRI findings of 21 patients with pathologically confirmed PAS were analyzed retrospectively.Results All PAS lesions involved the central pulmonary artery,of which 15 cases involved the main pulmonary artery and bilateral pulmonary artery trunks,4 cases involved the main pulmonary artery and right pulmonary artery trunk,1 case involved the main pulmonary artery and left pulmonary artery trunk,and 1 case involved the right pulmonary artery trunk.Five cases involved the pulmonary artery valve and right ventricular outflow tract as well.Nineteen cases of PAS showed complete filling defects in the central pulmonary artery,and the other 2 cases presented with nodular or lobulated filling defects attached to the pulmonary artery wall.The proximal margin of 19 PAS lesions was bulging or lobulated,and the distal pulmonary artery of 9 PAS lesions showed aneurysm-like dilatation.On MRI,all 13 cases of PAS were hyperintense on fat-suppressed T2WI,of which 11 cases were hyperintense on diffusion weighted imaging(DWI),and all lesions demonstrated significantly heterogeneous enhancement or delayed enhancement.Conclusion On computed tomography pul-monary angiography(CTPA),filling defects which grow expansively in the central pulmonary artery,and which have proximal bul-ging shape or distal aneurysm-like dilatation are highly suggestive of PAS.On contrast-enhanced MRI,the significantly heterogene-ous enhancement mass in the central pulmonary artery should be highly suspected of PAS.

Objective To assess the predictive value of computed tomography pulmonary angiography(CTPA)cardiovascular parame-ters for chronic thromboembolic pulmonary hypertension(CTEPH)under the 2022 European Society of Cardiology/European Respiratory Society(ESC/ERS)guidelines,and to compare with the 2021 Chinese guidelines.Methods A total of 201 suspected CTEPH patients were retrospectively selected.All patients underwent right heart catheterization(RHC)and CTPA evaluation.According to the Euro-pean guidelines,they were divided into three groups:mean pulmonary artery pressure(mPAP)≤20 mmHg control group(63 cases)(1 mmHg=0.133 kPa),mPAP＞20 mmHg CTEPH group(138 cases),and mPAP≥25 mmHg CTEPH group(123 cases).Inter-group comparison of CTPA cardiovascular parameters was performed,and receiver operating characteristic(ROC)curve analysis was performed for each parameter.Results Under the 2022 European guidelines,the diagnostic efficacy of the diameter of the main pulmonary artery trunk(MPAd)was the highest[area under the curne(AUC)was 0.933].The binary logistic regression analysis revealed that the MP Ad,right ventricular free wall thickness(RVWT),and interventricular septal angle(IVSA)were inde-pendent risk factors for the diagnosis of CTEPH(P＜0.05).Under both the Chinese and European guidelines,the MPAd,the transverse diameter and area of the right atrium,the transverse diameter and area of the bi-ventricle,the RVWT,and the IVSA showed significant statistical differences in CTEPH and control groups(P＜0.05).Conclusion Under both the Chinese and European guidelines,the MP Ad measured by CTPA has the highest diagnostic efficacy for CTEPH,while the IVSA has the strongest correlation with clinical prognostic indicators.The right atrium structure also has evaluation value.

Objective To establish a county-level trauma treatment model,designed to prioritize efficiency and guided by a multidisciplinary approach for emergency green channels.Methods Adhering to the Consensus of Experts on the Construc-tion and Management of Trauma Centers in Municipal Comprehensive Hospitals(2020),and using the trauma center creation plan from Guangdong Province as a reference,we established a county-level trauma center,leveraging its strengths and unique at-tributes,with the emergency department as its core.Results The application of information technology facilitated the establish-ment of a two-way referral information platform and a three-tiered diagnosis and treatment system for county medical communities,thereby enhancing the efficiency and quality of healthcare.The implementation of the emergency green channel multidisciplinary treatment team model significantly improved the admission rates for complex and critical cases and increased the utilization of new technologies.Conclusion The development of a county-level emergency treatment system,spearheaded by the establishment of a provincial-level trauma center and a multidisciplinary team model for emergency green channels,can expedite trauma patient care,augment diagnostic efficiency and treatment efficacy,and catalyze advancements in medical technology within county hospitals.

This paper mainly introduces the definition of inter-hospital transport and "hub-and-spoke" transport network in patients with extracorporeal membrane oxygenation (ECMO) , and reviews the safety management of inter-hospital transport among patients with ECMO from four aspects of transport team, transport mode, transport equipment, and transport adverse events, in order to provide reference for improving patient safety and the quality of transport care.

This paper explores the factors influencing the health-related quality of life (HRQL) of adult patients undergoing extracorporeal membrane oxygenation (ECMO) from five dimensions based on the health ecology model: personal characteristics, behavioral traits, interpersonal networks, work and living environment, and policy environment. The aim is to provide a theoretical basis for proposing evidence-based interventions to effectively improve the HRQL of adult ECMO patients.

Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)is the main pathogen that causes COVID-19,which is fast-mutating and highly transmissible.The infection has led to a global epidemic.As the main preventive and control measure,vaccination plays a critical role in fighting a-gainst COVID-19.Although a large number of epitope-based and mucosal vaccines have been stud-ied,few peptide epitope vaccines targeting the mucosa and their functional evaluation have been re-ported.In this study,we used SARS-CoV-2 structural protein M peptide epitope predicted by the IEDB database as an antigenic target to design the MS-3S gene containing 3 050 and 1 229 signal peptides and DCpep optimized for insertion into MS2 phage coat proteins.The expression plasmid pSIP:MS-3S was constructed by cloning the PCR fragments seamlessly and was transformed into Lactiplantibacillus plantarum 18 to obtain the recombinant bacterium LP18:MS-3S.Expression conditions such as induction time,inducer concentration,rotational speed and initial pH were opti-mized.The intranasal immunization experiments were performed to examine the vaccine efficacy.The results showed that the 916 bp-long target gene MS-3S modified and optimized was amplified and used to successfully construct the recombinant bacterial strain LP18:MS-3S.The optimal con-ditions for recombinant protein expression were obtained and verified by Western blot,flow cy-tometry,immunofluorescence and other detection methods.The optimal expression conditions were determined as follows:induction time was 4 h with 100 pg/L of SppIP as the optimal induction concentration.Antibody-specific for the epitope was verified by ELISA experiments in serum,alve-olar lavage fluid and fecal dilutions of mice.In summary,a recombinant bacterial strain expressing the epitope antigen of the SARS-CoV-2 M protein peptide was constructed.The obtained protein can induce the body to produce humoral and mucosal immunity,which lays the foundation for the development of a vaccine candidate for the mucosal immunity of COVID-19.

As a ligand-dependent transcription factor,retinoid-associated orphan receptor γt(RORyt)that controls T helper(Th)17 cell differentiation and interleukin(IL)-17 expression plays a critical role in the pro-gression of several inflammatory and autoimmune conditions.An emerging novel approach to the therapy of these diseases thus involves controlling the transcriptional capacity of RORyt to decrease Th17 cell development and IL-17 production.Several RORyt inhibitors including both antagonists and inverse agonists have been discovered to regulate the transcriptional activity of RORyt by binding to orthosteric-or allosteric-binding sites in the ligand-binding domain.Some of small-molecule inhibitors have entered clinical evaluations.Therefore,in current review,the role of RORyt in Th17 regulation and Th17-related inflammatory and autoimmune diseases was highlighted.Notably,the recently developed RORyt inhibitors were summarized,with an emphasis on their optimization from lead compounds,ef-ficacy,toxicity,mechanisms of action,and clinical trials.The limitations of current development in this area were also discussed to facilitate future research.

Objective Using event-related potentials(ERPs),to study the effect and mechanism of negative emotion accumulation hepatic insufficiency on working memory in normal people.Methods Fifty subjects in each of the emotionally stable group and emotionally unstable group were given two load tasks(0-back and 1-back)in the N-back paradigm,the reaction time and correct rate were recorded,and the ERPs components N200 and P300 were detected.The latency and amplitude of P300 were analyzed statistically.Results ①Compared with the emotionally stable group,the emotionally unstable group had a longer reaction time(P<0.05).②Compared with the emotionally stable group,the subjects in the emotionally unstable group had prolonged N200 latency,decreased P300 amplitude significantly(P<0.05),and P300 latency had a tendency to extend(P<0.1).Conclusion Long-term accumulation of negative emotions and liver failure in normal people have the performance of decreased working memory,which may be related to the reduction of attention resource allocation and the impairment of cognitive processing function.

Natural long-chain alkanol and alkyl carboxylic acid were used to prepare novel hydrophobic deep eutectic solvents(HDESs).These HDESs are liquid at room temperature and have low viscosity(＜12.26 mPa-s),low polarity(lower than that of methanol,ChCl-based deep eutectic solvents and other reported HDESs),and low density(＜0.928 g/mL).A simple one-pot method based on a novel HDES-water two-phase extraction system was constructed for the extraction of weak-polarity bioactive components,anthraquinones,from Rhei Radix et Rhizoma.This HDES-based new extraction method does not consume hazardous organic solvents and can obtain a total anthraquinone yield of 21.52 mg/g,which is close to that obtained by the Chinese pharmacopoeia method(21.22 mg/g)and considerably higher than those by other reported HDESs-based extraction methods(14.20-20.09 mg/g,p＜0.01).The high extraction yield can be mainly attributed to the severe destruction of the RRR cell walls by the extraction system and the excellent dissolving ability of novel HDESs for anthraquinones.